WASHINGTON—Hyperkalemia reduces the quality of life of chronic kidney disease (CKD) and dialysis patients, according to 2 new studies presented by Eskinder Tafesse, PhD, of AstraZeneca, and collaborators at the American Society of Nephrology’s Kidney Week 2019 meeting.

Investigators pooled and analyzed responses from 1249 patients in the Adelphi CKD Disease Specific Programmes 2015 and 2018. The first study examined KDQOL-36 responses. Dialysis and CKD patients with hyperkalemia (more than 5.0 mmol/L) reported significantly lower quality of life scores than CKD patients without hyperkalemia (the reference group) across all 5 domains.

  • Burden of kidney disease: 46.96 vs 57.61 vs 62.44, respectively
  • Symptoms/problems: 76.77 vs 80.03 vs 83.67, respectively
  • Effect of kidney disease on daily life: 61.26 vs 69.68 vs 78.42, respectively
  • SF-12 physical summary score: 38.39 vs 39.37 vs 41.81, respectively
  • SF-12 mental summary score: 45.85 vs 45.53 vs 47.42, respectively

Among dialysis patients, those with hyperkalemia reported worse scores in 2 domains than those without hyperkalemia: symptoms and problems (76.77 vs 78.6) and adverse effects of kidney disease on their lifestyle (61.26 vs 68.29). Dialysis patients with hyperkalemia also had lower employment and greater need for caregiver support than the other groups.

Importantly, hyperkalemic dialysis patients had more difficulty in reducing their dietary intake of potassium than those without hyperkalemia.

The second study examined results from the EuroQol-5D-3L (EQ-5D) questionnaire (covering 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and the EuroQol visual analog scale (EQ-VAS). Again, dialysis and CKD patients with hyperkalemia had significantly lower mean EQ-5D utility scores than CKD patients free of hyperkalemia (0.755 vs 0.788 vs 0.825, respectively). Significantly lower mean scores were likewise reported on the visual analog scale: 62.3 vs 64.7 vs 67.5, respectively.

Again, hyperkalemia patients reported more difficulty with reducing dietary potassium than their peers without hyperkalemia. Over a third a patients made no changes to their diet despite physician recommendations.

“In order to understand how to optimize patient care and improve patient outcomes, it is important to first understand the distinct challenges that they face today,” Mike Palmer, global head of market access and pricing, Cardiovascular Renal & Metabolism, at AstraZeneca told Renal & Urology News. “These two studies provide important perspectives on the impact of hyperkalemia in chronic kidney disease patients’ quality of life, whether they are dialysis dependent or non-dialysis dependent. Data suggest that new therapeutic options, liberalization from dietary restrictions and effective management of hyperkalemia in dialysis-dependent CKD patients may positively improve quality of life in this population.”

“Innovative hyperkalemia treatment approaches and less dietary restrictions should be important considerations by physicians to contribute to improved quality of life in this patient population,” Dr Tafesse’s team concluded.

In both studies, the researchers adjusted for patient age, sex, estimated glomerular filtration rate, heart failure, and diabetes.

The 2 studies were funded by AstraZeneca, the producers of the hyperkalemia drug sodium zirconium cyclosilicate (Lokelma®).

References

Tafesse E, Jackson J, Moon R, et al. Patient-reported quality of life in dialysis compared with non-dialysis CKD patients with hyperkalemia in the United States and European Union 5: Results from the KDQOL. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5-10, 2019 in Washington DC. Abstract TH-PO231.

Tafesse E, Jackson J, Moon R, et al. Assessing the impact of hyperkalemia on the quality of life of dialysis patients compared with non-dialysis patients: Results from a real-world study in the United States and European Union 5. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5-10, 2019 in Washington DC. Abstract TH-PO235.